COIN: Center for Clinical Management Research (CCMR); Ann Arbor, MI

Director: Eve Kerr, M.D., M.P.H.

About the COIN

CCMR combines the expertise of more than 40 scientists from the VA Ann Arbor Healthcare System, collaborates with researchers across the nation, and partners with VA clinical leaders and managers, in order to implement and evaluate different ways to make healthcare more patient-centered, effective, safer, and more affordable. CCMR's mission is to advance knowledge, promote innovations, and engage in collaborations that will improve the health and health care of Veterans and the nation.

Focused Areas of Research

Center scientists focus their efforts in three critical areas driven by important challenges in clinical management:

Veteran-centered Care

CCMR will focus on developing and promoting Veteran-centered and personalized decision-support tools and performance measures that increase appropriateness
of care.This work is driven by statistical analyses and modeling that consider patient preferences and individual risk factors, rather
than relying on guidelines and performance measures based on averages. In addition to developing better measures of patients' risk and treatment benefits,
this research includes determining the best ways to implement these tools in clinical practice settings, to facilitate their use by both providers and
patients. The ultimate goal is to promote high-value care, while discouraging inappropriate or low-value care.

Patient Safety and Outcomes for Vulnerable, High-risk, and Complex Patients

CCMR will target two especially vulnerable patient sub-groups: 1) Veterans with significant mental health problems, and 2) hospitalized medical patients.
Their research includes developing systematic approaches to identifying Veterans at high risk, including registries and systems for tracking potentially
risky healthcare practices. CCMR is developing, testing, and implementing strategies that reduce the risk of adverse outcomes in these populations. These
strategies are primarily focused on clinical and systems-based approaches to promote improvements in Veterans' healthcare delivery and outcomes.

Patient Self-Management and Treatment Engagement

CCMR's research in this area focuses on developing, testing, and implementing tools and services that leverage health technology, caregivers, and peer
partners to assist PACT teams and other providers to improve Veterans' self-management and treatment engagement. This research is producing resources
designed to:

Increase the efficiency of support for self-management and behavior change;

Increase the accessibility and effectiveness of these supports for Veterans; and

Decrease the adverse impacts of complex chronic disease on Veterans, their family, and other informal caregivers.